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Related Concept Videos

Parentral Nutrition: Centeral and Peripheral Parental Nutrition01:27

Parentral Nutrition: Centeral and Peripheral Parental Nutrition

97
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
97

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Comparing Midline and Peripherally Inserted Central Catheters: A Randomized Feasibility Trial.

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A feasibility trial comparing peripherally inserted central catheters (PICCs) and midline catheters in children was not practical due to low PICC use. Further research may focus on catheter selection algorithms.

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Area of Science:

  • Pediatric vascular access
  • Clinical trial feasibility
  • Medical device comparison

Background:

  • The optimal use of midline catheters versus peripherally inserted central catheters (PICCs) in pediatric patients requires further investigation.
  • Durable vascular access is crucial for hospitalized children requiring medium-term (5-14 days) noncentral venous access.

Purpose of the Study:

  • To assess the feasibility of a randomized controlled trial (RCT) comparing PICCs and midline catheters in children.
  • To gather preliminary data on the effectiveness of these two vascular access devices.

Main Methods:

  • A single-site study combined a randomized controlled feasibility trial (RCT) and a prospective observational study.
  • Hospitalized children aged 2-17 years needing 5-14 days of vascular access were enrolled.
  • Primary RCT outcome was a 4-measure feasibility assessment; secondary outcomes included time-to-removal and failure rates.

Main Results:

  • Only 43 of 260 screened patients met eligibility criteria, primarily due to reduced PICC utilization.
  • 35 patients were enrolled: 8 in the RCT (4 per arm) and 27 in the observational study.
  • The RCT's enrollment goal was not met, but other feasibility metrics (enrollment rate, intervention adherence, acceptability, data completeness) were achieved.

Conclusions:

  • A comparative trial of PICCs and midline catheters may not be feasible for evaluating midline catheter effectiveness in children due to decreased PICC use.
  • Future research should consider hybrid effectiveness-implementation studies, potentially involving an intravenous catheter selection algorithm.